Back pain - Diagnosis
In this section
Your back pain will probably get better by itself. But you may wish to see your doctor if the pain is bad, if you are worried about it or if it doesn't get better after a few weeks.
Your doctor probably won't be able to find what's causing your back pain. But he or she will be able to check that it isn't caused by more serious health problems.
Seeing your GP
Your GP will ask you some questions about how and when your symptoms started. And you'll probably have a physical examination.[1] This helps to rule out some serious conditions that can cause back pain and sciatica. Sciatica is when you get a pain that runs down your leg. It can be caused by a damaged disc pressing on the nerves that join up with the sciatic nerves in your legs.
Your doctor will ask you about the pain and other feelings you have in different parts of your legs, feet and toes. Your doctor may give you a pinprick on the back of your leg or on your foot to check that your sense of touch is working properly.
Your doctor may test the strength of your muscles by asking you to push against his or her hand. Your doctor will also test your reflexes in your knees and ankles by gently tapping with a special hammer just below your kneecaps and above your heels.
Straight leg test
Doctors often use the straight leg test to help find out if you have a damaged disc. Your doctor may ask you to lie on your back and then raise the painful leg, without bending your knee. Most people with a damaged disc get sciatica (a pain that runs down one leg) before their leg is two-thirds of the way up. It means you are likely to have a slipped disc.[1] To learn more, see our articles on Slipped disc.
After this test, your doctor may be able to reassure you that your back pain is not serious and will probably clear up on its own. He or she may give you advice about how to look after your back. If you have had back pain for more than 12 weeks, he or she may also suggest some exercises that could help. Your doctor can also prescribe painkillers if you need them.
Seeing a specialist
Most cases of back pain get better on their own within a few weeks, so you probably won't need to see any other doctors apart from your GP. But if your back pain doesn't go away, your GP may refer you to a doctor who specialises in back problems.
You may be offered an MRI scan (a scan that uses a magnetic field) to check if the cause of your back pain is a slipped (damaged) disc, and to rule out more serious problems, such as cancer. You may also be offered a CT scan (a type of X-ray), but specialists think the MRI scan is better at finding out if anything is seriously wrong.
If you have had a fracture or an infection, or if your doctor thinks you may have cancer in your bones, you might have a bone scan. Pictures from the scanner usually show any areas where there is something unusual. If people do have tumours in their bones, most of them will show up in this type of scan.
Another type of scan, called a bone density scan, measures how thick your bones are. It is used to see if you have osteoporosis, which is a condition in which your bones become weak and brittle.
Usually, X-rays aren't used on their own to find out what is causing back pain.[2] Although they can help to show any wear and tear of the spine, that's seen just as often in people who don't have back pain. So, having an X-ray won't help doctors to decide what's causing your back pain.[2]
References
- Deyo RA, Weinstein JN. Low back pain. New England Journal of Medicine. 2001; 344: 363-370.
- Indahl A. Low back pain: diagnosis, treatment and prognosis. Scandinavian Journal of Rheumatology. 2004; 33: 199-209.
Glossary
- MRI scan
- A magnetic resonance imaging (MRI) machine uses a magnetic field to create detailed pictures of the inside of your body.
- CT scan
- A CT scan is a type of X-ray. It takes several detailed pictures of the inside of your body from different angles. CT stands for computed tomography. It is also called a CAT scan (computed axial tomography).
- X-ray
- X-rays are pictures taken of the inside of your body. They are made by passing small amounts of radiation through your body and then onto film.
- bone scan
- A bone scan is a test to see if an infection or cancer has spread to a bone. It involves the injection of a substance into your blood stream that is taken up into your cells that have been affected by a disease. If the disease has spread to your bone, the areas it is in will glow brightly on X-rays.
- osteoporosis
- Osteoporosis is when your bones get too brittle. It happens if not enough new bone tissue is growing to keep bones strong. If you have osteoporosis, the bones in your body may break easily.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
